Healthcare Provider Details

I. General information

NPI: 1376252643
Provider Name (Legal Business Name): SAIRA J RIOS CONTRERAS DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2022
Last Update Date: 11/16/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 BONITAS LOOP
SANTA FE NM
87507-3633
US

IV. Provider business mailing address

3020 BONITAS LOOP
SANTA FE NM
87507-3633
US

V. Phone/Fax

Practice location:
  • Phone: 505-692-9662
  • Fax:
Mailing address:
  • Phone: 505-692-9662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number55117
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: